It’s been more than 50 years since the surgeon general issued a report linking smoking to health hazards such as lung cancer and heart disease. Yet many still blame Big Tobacco for continued cigarette consumption despite the industry’s efforts to inform consumers of associated health risks. Even worse, tobacco harm reduction products (THP) and other industry methods to mitigate health dangers are being attacked and undermined by anti-smoking zealots.

Since the 1964 report, tobacco companies have implemented government-mandated health warnings on cigarette packages and bans on commercial advertisements. Although smoking rates decreased extensively from the mid-60s to the mid-90s, opponents of smoking and regulatory agencies were, apparently, not satisfied. In 1994, the U.S. Food and Drug Administration (FDA) declared war on tobacco. For the first time, the agency sought to regulate nicotine. In the same year, The New England Journal of Medicine published a strategy to combat cigarette use, focusing on punishing tobacco companies through federal excise taxes, smoking restrictions, sponsorship and advertising bans, and ending federal subsidies for tobacco.

Things came to a head in 1998, when “the largest civil litigation settlement in U.S. history” was reached between four major tobacco manufacturers and 46 states and six U.S. territories. In the Master Settlement Agreement (MSA), tobacco manufacturers agreed to “annual payments in perpetuity” in return for states agreeing to forfeit future legal claims. Altogether, Big Tobacco agreed to pay “an amount equaling more than $200 billion for tobacco-related health care costs.”

Due to the MSA, states are receiving a windfall of tobacco money. Unfortunately, many states are not using these payments for the intended purpose: to curb smoking. During the “fiscal year 2018, states will collect a record $27.5 billion from tobacco taxes and legal settlements,” and will spend less than three percent — $721.6 million — on prevention and cessation programs,” according to the Centers for Disease Control and Prevention.

Despite their history, tobacco companies’ recent efforts to further reduce combustible cigarette consumption should be encouraged, not criticized. THR products have emerged as some of the most effective smoking cessation devices available today, and many tobacco companies produce them. These products include smokeless tobacco, electronic cigarettes and vaping devices, and heat-not-burn (HNB) products.

R.J. Reynolds introduced some of the first HNB products when it released Premier in the 1980s and a similar product, Eclipse, in the 1990s. Little developed until Ruyan, in 2007, introduced e-cigarettes. After a legal battle between another e-cigarette manufacturer and the Food and Drug Administration, the U.S. Court of Appeals ruled in 2012 that FDA could regulate e-cigarettes as tobacco products. There are now more than 460 different electronic cigarette brands.

Years ago, tobacco companies considered THR products to be a passing fad, but consumer desire for them has proven the opposite is true. This has sparked a plethora of innovations, product rollouts, and mergers.

Anti-smoking zealots refuse to acknowledge the benefits of THR products, despite overwhelming evidence that these products are significantly less harmful than combustible cigarettes. Thankfully, many public health groups, including Public Health England, the Royal College of Physicians, Cancer Research UK, NHS Health Scotland and the American Cancer Society, have acknowledged the benefits of THR.

Tobacco companies have a strong incentive to offer THR products. Responding to consumers’ demand for a safer alternative to cigarettes, these companies have spent millions in research and development on THR products.

Rather than limiting tobacco companies’ efforts to combat cigarette consumption, regulatory bodies and anti-smoking advocates should encourage industry innovations. Informed consumers are demanding safer alternatives, and Big Tobacco is responding accordingly. Ironically, it is now regulatory agencies, legislative bodies, and anti-smoking advocates that pose a public health risk by preventing access to THR products.

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